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41 <br /> PIENon-Discrimination Certification Form M® Supplemental Vendor Info: HUB Form <br /> County Non-Discrimination Ordinance and shall be grounds for rejection of the bid or <br /> proposal or termination of an existing contract,without fault or further obligation to Supplemental Vendor Information:HISTORICALLY UNDERUTILIZED BUSINESSES <br /> Orange County. Historically Underutilized Businesses(HUBs)consist of minority,women and disabled business firms that <br /> are at least fifty-one percent owned and operated by an individual(s)of the categories.Also included in this <br /> category are disabled business enterprises and non-profit work centers for the blind and severely disabled. <br /> 6. As a condition of submitting a bid or proposal to Orange County the undersigned Pursuant to G.S.1436-1361(a),143-48 and 143-128.4,the County invites and encourages participation in <br /> bidder or proposer agrees that Orange County may Consider the information submitted this procurement process by businesses owned by minorities, women, disabled, disabled business <br /> as part of this certification in its determination of the responsibility of the undersigned enterprises and non-profit work centers for the blind and severely disabled. This includes utilizing <br /> bidder or proposer. The undersigned bidder or proposer,as the case may be,waives subcontractors to perform the required functions in this RFP/RFQ.Any questions concerning NC HUB <br /> certification,contact the North Carolina Office of Historically Underutilized Businesses at(919)807- <br /> the right to challenge the rejection of a bid or proposal when such rejection is based,In 2330.The Vendor shall respond to question#1 and#2 below. <br /> its entirety,on information submitted as part of this certification. <br /> 1) Is Vendor a Historically Underutilized Business? ]Yes M No <br /> 2) Is Vendor Certified with North Carolina as a Historically Underutilized Business? ]Yes ® No <br /> The bidder or proposer certifies the undersigned has full authority to sign on its behalf. <br /> If so,state HUB classification N/A <br /> By: 45 l <br /> Chad Parker,Principal <br /> Printed Name and Title <br /> On behalf of Gensler <br /> Gensler Architecture,Design&Planning,P.C. <br /> Company or Corporate name <br /> Gensler 1 60 <br />